By Robert Michel, from the Volume XXIV, No. 14 – October 9, 2017 issue
Sept. 22 was the day that an agreement to sell Miraca Life Sciences (MLS) of Irving, Texas, was announced. Miraca Holdings will sell the anatomic pathology lab company to Avista Capital Partners. As part of the transaction, a new holding company, called Symphony Buyer, will be formed and will own MLS. Miraca Holdings will be
By Joseph Burns, from the Volume XXIV, No. 10 – July 17, 2017 issue
CEO SUMMARY: In five months, Medicare officials will implement a new Part B clinical laboratory fee schedule based on private payer lab price data submitted by certain medical laboratories required to report that data. At this year’s Executive War College, the CEO of XIFIN, Inc., reported on her company’s analysis of the payer price data
By Joseph Burns, from the Volume XXIV, No. 3 – February 21, 2017 issue
CEO SUMMARY: Following passage of the Protecting Access to Medicare Act of 2014, officials at PeaceHealth and PeaceHealth Laboratories began to model the financial effect this law would have on this long-established hospital lab outreach program. Based on projections of a 20% cut in revenue during the first two to three years of the Medicare
By Mary Van Doren, from the Volume XXIII, No. 16 - November 28, 2016 issue
This is an excerpt from a 2,700-word article in the November 28 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: THE DARK REPORT delivers the most detailed explanation ever offered of the payer-to-lab
By Joseph Burns, from the Volume XXIII, No. 16 - November 28, 2016 issue
CEO SUMMARY: In its work with more than 200 lab clients, XIFIN, Inc., of San Diego, sees the best and worst of problems in how labs submit claims to lab tests and how payers process these claims. In this exclusive interview, Lâle White, XIFIN’s Founder and CEO, identifies the systemic sources of problems in the
By Mary Van Doren, from the Volume XXIII No. 15 - November 7, 2016 issue
This is an excerpt from a 1,500-word article in the November 7 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: THE DARK REPORT presents the lab industry’s first look at actual price data
By Joseph Burns, from the Volume XXIII No. 15 - November 7, 2016 issue
CEO SUMMARY: In a new analysis of data its lab clients will use to report market prices to CMS, XIFIN Inc., reports private payers paid independent labs a weighted average price that was 19.6% less than what Medicare pays for 20 of its highest-volume tests. By contrast, private payers paid hospital labs with NPIs a weighted average
By Joseph Burns, from the Volume XXIII No. 11 – August 15, 2016 issue
CEO SUMMARY: For 10 years, three primary trends have reshaped the anatomic pathology profession. They are declining reimbursement, competition from physicians establishing in-office pathology labs, and a host of new government laws and regulations. More changes are coming, predicts one business expert in pathology. Those changes involve new Medicare payment models, along with opportunities for
By Joseph Burns, from the Volume XXIII, No. 7 - May 23, 2016 issue
CEO SUMMARY: Health insurers appear to have stepped up their efforts to warn clinical laboratories not to waive patients’ fees in return for specimen referrals. Consultants also say that payers are increasing enforcement efforts. There are cases where, when insurers discover labs have not collected fees from patients, they have hit labs with automatic payment
By Joseph Burns, from the Volume XXIII No. 5 - April 11, 2016 issue
CEO SUMMARY: Managed care experts say health insurers are being overwhelmed by the number of new genetic tests and that many labs find it tough to get paid for these tests. UnitedHealthcare just announced it will require pre-authorization of molecular and genetic tests during 2016. Meanwhile, Cigna, which already has pre-authorization in place for certain genetic tests, said it intends to
